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Marburg outbreak raises tropical disease profile

Posted on: 08 Apr 05

Summary

The death toll from the Marburg virus has now risen to over 150 in Angola making it the most serious such outbreak recorded. Although the Ebola-like virus has no vaccine or curative treatment and can be rapidly fatal, news of the outbreak should serve to focus attention back on the sometimes-neglected area of tropical disease management.

The virus first broke out in the Uige province of Angola in October 2004, where most cases are presently concentrated, but it has now spread to the capital, Luanda. Since the start of the outbreak, the monthly number of cases recorded has progressively increased, but this could be the result of intensified surveillance. Around 75% of cases have occurred in children under the age of five years.

The Marburg virus disease, first identified in 1967 during simultaneous outbreaks affecting laboratory workers in Marburg and Frankfurt, Germany, and in Belgrade, in the former Yugoslavia, is an acute febrile illness accompanied by severe hemorrhagic manifestations.

European assistance

The European Union announced that it would give $650,000 to fight the disease, highlighting the severity of this particular outbreak. In the absence of any effective treatments, strict measures for infection control need to be applied during the management of cases. Ensuring control of the epidemic may prove crucial to preventing further spread in Angola and, in addition to proving funding, the EU could also help implement infection control measures, such as solitary wards and sterile care for those affected by the epidemic.

The Marburg virus is clearly a rarely seen tropical infection, and, as such, an outbreak is likely to generate considerable coverage - especially given its resemblance to the similarly lethal, but more familiar, Ebola virus.

However, as the Marburg crisis is making the headlines at present, it offers an opportunity for pharma companies, developed world governments and other stakeholders (particularly NGOs operating in developing countries) to reassess how effective current tropical disease management strategies are in practice.

Industry impact

The impact of tropical diseases is heightened by the significant lack of resources and infrastructure necessary to deliver general medical care in many developing countries. Pharmaceutical companies can contribute by research and development into novel products, such as prophylactic vaccines, but it is clear the challenge lies beyond the clinical efficacy of treatments and needs to focus on the economic, political and logistical issues of combating such diseases.

Furthermore, a visible involvement in world health may be strategically useful: one obvious gain is that of positive public relations, creating an external image of a socially responsible corporation. Another factor, often overlooked, is the impact on employee loyalty and motivation. It has been suggested that corporate objectives that demonstrate concern for and commitment to public initiatives, or projects that are not solely driven by profit margins, can lead to considerable improvements in workplace productivity.

The investment of time and resource into tropical infection research will also ultimately involve interaction with supranational organizations and NGOs. Establishing such relationships and maintaining them favorably might lead to future advantages in other fields, with greater financial potential. This may also help to alleviate the pressure currently being placed on pharmaceutical companies to supply drugs at lower prices, through the creation of additional lobbying power and influence.

Wider implications

Although tropical diseases are not endemic in the western World, the rise in international tourism and economic migration has meant that more people from developed countries are now at risk from infection. Undoubtedly, awareness of the seriousness of tropical diseases, previously thought to be of low priority, has risen in recent years, and this latest outbreak serves as an effective reminder.

This increased awareness has created renewed demand for effective pharmaceuticals for use in the traveling population and military personnel. Urban areas, mainly populated by new immigrant populations, are also becoming significant target populations for treatments directed to diseases, such as tuberculosis.

The Angolan outbreak therefore offers a chance for the industry to once gain focus on the issue of tropical disease management which, although unlikely to provide significant long-term financial benefits, is an area that - for reasons of corporate ethics and wider public health in both the developed and developing world - should not be overlooked.

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